SGN2004-00336 A C ITY OF TIGARD SIGN PERMIT
t DEVELOPMENT SERVICES PERMIT #: SGN2004 -00336
4 13125 SW Hall Blvd., Tigard, O R 97223 (503) 639 -4171 DATE ISSUED: 11/17/2004
PARCEL: 2S 112AB -R -O -W
BUSINESS NAME: ZONE:
SIGN LOCATION: SW NO ADDRESS JURISDICTION: TIG
APPLICANT /AGENT: OBIE MEDIA CORPORATION
BUSINESS TAX NO:
SIGN
PERMANENT: X FREESTANDING: FREEWAY:
TEMPORARY: WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 24" X 84"
TOTAL SIGN AREA: 14 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: ft.
PROJECTION FROM WALL: in.
ILLUMINATION:
DESCRIPTION OF SIGN: Placement of one bench with sign within public right -of -way. Approved by Gus
Duenas (City Engineer).
MATERIALS: BENCH
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. A permanent sign must be
placed within 90 days from approval date or sign permit shall expire. A temporary sign shall expire 30 days from validity
date. A balloon sign shall expire 10 days from validity date. /
APPROVED BY: `A /AAA l �'t ',
PERMITTEE SIGNATURE: a. c c & `—
DATE: 11/17/2004
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Alt.,.. sin N , l 'ER: \, IT AP , g l! LI C T111) hv�. E.!� J�s
CITY.OF TIOARb 13125 SPY Hall Blvd Tigard, OR 97223 (503)V39-4171 FAX (503) 689 -7297
as1IAM
•
GENERAL INFORMATION • -
Name of Development/Project FOR STAFF USE ONLY,
Site /145 � /b� h �{� /
Address/ Street Address (A/ esF $� "e - c• K yio a7 Permit No:: SCSI) a 004 — °
Location 5 ? a te ( / I'/ Expiration Date:
Suite/Bldg. # City/State D P • 7 � Z Receipt #:
Nam /� / Approved By:
Property
P it' 4/ k - /` 47 4J z/ Date:
Owner Mailing A Suite Map/TL #:
dre 7n Zoning:
City /State Zip Phone
Electrical Permit Required? ❑ Yes ❑ No.
Tenant or Name //�� C Building Permit Required? ❑ Y es ❑ No
Business /l � s J �d
Sign Name Rev. fit-Jul-02 I:lcurpinVnasters\revlsed\slen permit app.doc
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REQUIRED SUBMITTAL ELEMENTS
Contractor Mailing Address .,-i Suite
(Prior to permit ep // I 1It= live (Note: applications will not be accepted '
issuance, a without the required submittal elements) •
copy of all City/State Zip Phone ! a I
licenses are eb & � �G/l ^6r
req uired L it �7 2 `{ Completed Application Form
expired in the Ortifon Const. Cont. Board Exp. Date
City of Tigard's License # ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
database) oet t '' /1 °`"`.' • (3 copies, if a building permit is required)
Proposed ❑ permanent ❑ Freestanding ❑ Freeway size requirement: 8 x 11 ", or 11" x 1T
Sign 0 Temporary ❑ .wall CI Electronic ❑ 2 copies of elevations, drawn to scale
(Check all that W3 Other e z ❑ B illboard ❑ Ba lloon
a•• (3 copies, if a building permit is required)
❑ . New sign? ❑ Alter to existing sign? size requirement: 81/2" x 11", to 24" x 36"
Sign Dimensions: t/ if 7} / /y i, 0 $30.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.)): f ! ❑ $15A0 Fee (Temporary sign, any ty ) _rife Total Wall Area (sq. ft.) 1 / �p ,0�j 7-D O
Sign Data (V LC •
(Complete all Direction Wall Faces (circle one): . NOTES:
Items in this
section) N S E W NE "NW SE SW a Wall signs do not need to be drawn to scale,
Height to top of sign (feet): _ i but must Include dimensions of wall face and
Projection From Wall (inches): • . sign placement,
Copy: • • Wall signs do not require site /plot plans.
Materials: o Freestanding signs over 6 ft. required a ,
building permit.
Will sign have illumination? ❑ Yes 01 No , o If work authorized under a sign permit has not
Type: ❑ Internal ❑ External been completed within ninety (90) days after
Are there any existing freestanding or wall signs at this the issuance of the permit, THE PERMIT WILL
location, including wall signs that overlap a tenant space? BECOME NULL AND VOID.
❑ Yes [g No •
If "yes ", a list or diagram of all sign dimensions and
s • uare footage must also be submitted.
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Ao S( j .
(OVER FOR SIGNATURES)
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' I hereby acknowledge that ! have read this application, that the information given is
correct, that I am the owner or authorized agent of the owner, and that plans submitted are
in compliance with the City of Tigard.
n� .
DATED this d ay of / , 20 0 q
Signature of Owner /Agent
O r!eYt St-Li ,e n
ogre �iev o� 5 3 - Z 2- 3- 774
Contact Person Name Phone No.
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CITY OF TIGARD 11/18/2004
13 12 5 SW Hall Blvd. 10:05:06AM
x it � Tigard, Oregon 9 72 23
6 1L, � (50 3) 63 9-4 17 1 '
Receipt #: 27200400000000005009
Date: 11 /18/2004
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2004 -00332 [SIGN] Sign Permit 100 - 0000 - 437000 30.00
SGN2004 -00333 [SIGN] Sign Permit 100- 0000 - 437000 30.00
SGN2004 -00334 [SIGN] Sign Permit 100- 0000 - 437000 30.00
SGN2004 -00335 [SIGN] Sign Permit 100- 0000 - 437000 30.00
SGN2004 -00336 [SIGN] Sign Permit 100- 0000 - 437000 30.00
SGN2004 -00337 [SIGN] Sign Permit 100- 0000 - 437000 30.00
SGN2004 -00338 - [SIGN] Sign Permit 100 - 0000 - 437000 30.00
SGN2004 -00339 [SIGN] Sign Permit 100- 0000 - 437000 30.00
SGN2004 -00340 [SIGN] Sign Permit 100- 0000 - 437000 30.00
SGN2004 -00341 [SIGN] Sign Permit 100- 0000 - 437000 30.00
Line Item Total: $300.00
Payments:
Method Payer User ID Acct. /Check Approval No. How Received Amount Paid
Check OBIE MEDIA CORPORATION CAC 67864 In Person 300.00
• Payment Total: $300.00
cReceipt.rpt Page 1 of 1